Natural orifice transluminal endoscopic surgery (NOTES) is preferred over traditional open body surgery because the latter leaves scars, is prone to causing infection of access incision sites, and use of access incisions is associated with increased risk for hernia and formation of adhesions. In addition, natural orifice surgery is an improvement over minimally invasive surgery (MIS), which uses 3-5 access incisions with each incision associated with a scar, risk for infection, and risk for hernia. In natural orifice surgery, the operating site is reached via a natural opening. Also, in single port access surgery (SPAS) a single small incision is used to provide access to the anatomy.